Operational model of geriatric clinic in health facilities under the 1st to 12th health zones, Ministry of Public Health in the Thai context: A sequential mixed-method study

Abstract

This mixed-methods based on sequential approach aimed to explore the operational model of geriatric clinics across healthcare facilities at all levels under the Ministry of Public Health, within the 1st to 12th health zones of Thailand. The sample for the quantitative research consisted of those responsible for geriatric clinics, service providers, and clients. The sample for the qualitative research includes administrators/policy makers, geriatric clinic staff, and clients. The study area was selected using stratified random sampling based on the proportion of geriatric clinics meeting the standard criteria (50%) and the distribution of healthcare facilities across different levels, totaling 450 facilities. These included 1) 45 facilities at Levels A and S, 2) 66 facilities at Levels M1 and M2, and 3) 339 facilities at Levels F1, F2, and F3. Data were collected using questionnaires, structured interviews, and focus group discussions with structured question guides. Quantitative data were analyzed using descriptive statistics, including frequency, percentage, and mean; while qualitative data were analyzed through content analysis based on the research themes.
The study found that 397 healthcare facilities responded to the questionnaire. These included 55 facilities categorized as A and S levels, 63 facilities categorized as M1 and M2 levels, and 279 facilities categorized as F1, F2, and F3 levels. Of these, 99.5% had established elderly care clinics. Service models showed that 59% operated stand-alone elderly care clinics, 2.62% combined elderly care with non-communicable diseases clinics, and 17.04% provided mobile elderly care clinics within the community. Clients expressed satisfaction with the care, particularly the health consultation provided by multidisciplinary teams, and indicated a desire to utilize the services more frequently. Service providers demonstrated a positive attitude toward older clients, taking care for older clients as they would care for older persons in their own families. Persons relevant to this policy emphasized the need for implementing this policy continuously and enhancing the standards to ensure the quality of services. They also perceive these services as a critical policy and be responsible for implementing in the community continuously.
The findings could be used to drive policy initiatives and to launce the geriatric clinics. These insights could also be adapted and applied across all levels of healthcare facilities continuously. This would improve the accessibility to the healthcare services for the older persons to get the comprehensive care systematically and thoroughly, contributing to the well-being of the Thail aging population.